1
|
Factors associated with diabetes-related distress among Asian patients with poorly controlled type-2 diabetes mellitus: a cross-sectional study in primary care. BMC PRIMARY CARE 2023; 24:54. [PMID: 36849921 PMCID: PMC9969642 DOI: 10.1186/s12875-023-02012-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/20/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Diabetes-related distress (DRD) is a negative emotional state related to the burden of living with diabetes mellitus. It has been associated with poor self-care and glycaemic control. This cross-sectional study aimed to examine the factors associated with DRD among urban Asian patients with poorly controlled type-2 diabetes mellitus (T2DM) in primary care in Singapore. The factors included demographics, diabetes history, medical co-morbidities, mood disorders and social history. METHODS Patients with T2DM and HbA1c of 8% or more were recruited from 2 public primary care centres in Singapore. They were administered a questionnaire survey to identify DRD based on the Problem Area In Diabetes (PAID) scale. Their anxiety and depression were screened using GAD-7 and PHQ-9, and quality of life (QOL) measured using the EQ-5D-5L. Their clinical data, including HbA1c, comorbidities and medications, were extracted from the electronic medical records. RESULTS Among the 356 subjects, the prevalence of DRD was 17.4%. DRD was significantly associated with younger age (AOR (95% CI) = 0.93 (0.89-0.97), p = 0.001), ex-smoker status (AOR (95% CI) = 22.30 (2.43-204.71), p = 0.006) and history of kidney disease (AOR (95% CI) = 3.41 (1.39-8.35), p = 0.007). Those who screened positive for depression (AOR (95% CI) = 4.98 (1.19-20.86), p = 0.028) were almost five times more likely to have DRD. Quality of life was lower among those with DRD (EQ5D index score AOR (95% CI) = 0.11 (0.01-0.97), p = 0.047), who also tended to feel that diabetes pharmacotherapy interfered with their normal life (AOR (95% CI) = 2.89 (1.38-6.08), p = 0.005). CONCLUSION About 1 in 6 patients with poorly controlled T2DM had DRD. Younger age, ex-smoker status, history of kidney disease, and those with depressive symptoms were most at risk.
Collapse
|
2
|
Nikou S, Lindman I, Sigurdsson A, Karlsson L, Öhlin A, Senorski EH, Sansone M. Arthroscopic iliopsoas tenotomy after total hip arthroplasty: safe method for the right patient. J Exp Orthop 2023; 10:3. [PMID: 36652032 PMCID: PMC9849514 DOI: 10.1186/s40634-023-00568-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To evaluate the outcome of arthroscopic treatment for iliopsoas impingement after total hip arthroplasty (THA) 2 years after surgery using patient reported outcomes (PROM). METHODS In this study 12 patients (13 hips) were included from a local hip arthroscopy registry. Patients completed web-based PROMs preoperatively and at a minimum of 2 years postoperatively. The PROMs included the International Hip Outcome Tool short version (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS), the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the Hip Sports Activity Scale (HSAS) for physical activity level, the Visual Analog Scale (VAS) for overall hip function and a single question regarding overall satisfaction with the surgery. RESULTS The mean age was 64.4 years (±15.1SD), mean body mass index (BMI) was 26.6 (±4.3SD), mean follow-up time was 49.8 months (±25SD). Comparing PROMs preoperatively with 2-year follow up showed an improvement for many of the PROMs used. The PROMs scores were iHOT-12 (24.9 vs 34.5, p = 0.13), HAGOS subscales (symptoms 38.2 vs 54.5, p = 0.05; pain 36 vs 53, p = 0.04; sport 14.1 vs 35.1, p = 0.03; daily activity 31 vs 47.5, p = 0.04; physical activity 21.8 vs 24, p = 0.76; quality of life 24 vs 35, p = 0.03), EQ-VAS (57.9 vs 58, p = 0.08), EQ-5D (0.34 vs 0.13, p = 0.07) and VAS for overall hip function (43.1 vs 46.2, p = 0.14). In total, 10 out of the 12 patients (83%) were satisfied with the intervention. CONCLUSION Patients undergoing surgery for iliopsoas impingement after previous THA showed improved self-reported hip function where most patients were satisfied with treatment.
Collapse
Affiliation(s)
- Sarantos Nikou
- grid.8761.80000 0000 9919 9582Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,Department of Orthopaedic Surgery, South Älvsborg Hospital, 501 82 Borås, Sweden
| | - Ida Lindman
- grid.8761.80000 0000 9919 9582Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Arnar Sigurdsson
- grid.8761.80000 0000 9919 9582Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Louise Karlsson
- grid.8761.80000 0000 9919 9582Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Axel Öhlin
- grid.8761.80000 0000 9919 9582Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eric Hamrin Senorski
- grid.8761.80000 0000 9919 9582Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Sansone
- grid.8761.80000 0000 9919 9582Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
3
|
Robinson T, Oluboyede Y, Vale L, Olariu E. Differences in health-related quality of life between the Roma community and the general population in Romania. J Patient Rep Outcomes 2022; 6:127. [PMID: 36547744 PMCID: PMC9780407 DOI: 10.1186/s41687-022-00530-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous research has shown that Roma people report worse health outcomes than the general population and suffer from a myriad of economic and social disadvantages. The objective of this study was to assess the differences in the health-related quality of life (HRQoL) between the Roma people and the Romanian general population. METHODS Two cross-sectional surveys were conducted face-to-face in 2018 and 2019 in two nationally representative samples of both the general population and Roma communities, recruited from all regions of Romania. Both samples completed the EQ-5D-5L and EQ-VAS questionnaires, as well as a range of sociodemographic questions. Coarsened Exact Matching and several different regression models were used to assess the differences in HRQoL between the two groups. RESULTS 2308 respondents were included in the matched sample: 1,621 general population individuals; 687 Roma people. Roma people had more problems with self-care, pain/discomfort, and anxiety/depression than the general population. They also reported a lower overall level of HRQoL than the general population of Romania, as reflected by the lower EQ-5D-5L and EQ-VAS scores. Our sensitivity analysis between Coarsened Exact Matching and other matching procedures showed consistent results across all regression models. CONCLUSIONS In Romania, the Roma community has a lower level of HRQoL than the general population. Understanding the underlying causes of this inequality should be the focus of future research. Policies aimed at reducing the level of health inequality between the Roma and the general populations should be promoted locally.
Collapse
Affiliation(s)
- Tomos Robinson
- grid.1006.70000 0001 0462 7212Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Yemi Oluboyede
- grid.1006.70000 0001 0462 7212Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Luke Vale
- grid.1006.70000 0001 0462 7212Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| | - Elena Olariu
- grid.1006.70000 0001 0462 7212Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle Upon Tyne, NE2 4AX UK
| |
Collapse
|
4
|
Hamdan A, Ghanim M, Mosleh R. COVID-19 confinement and related well being measurement using the EQ-5D questionnaire: A survey among the Palestinian population. Int J Clin Pract 2021; 75:e14621. [PMID: 34240509 PMCID: PMC8420358 DOI: 10.1111/ijcp.14621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/06/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This study aims to assess the effect of the COVID-19 confinement on the population wellbeing using the EQ-5D questionnaire. METHODS After receiving the written permission from the EuroQol Research Foundation, an online-based survey was prepared and a total of 1380 participants were recruited via social media. The relationships of all the factors were studied as well as the scores of the EQ-5D including EQ-5D Index, Visual Analogue Scale (VAS), and each of the EQ-5D dimension. Linear regression for the Index and VAS and Logistic regression model was used to examine each dimension. RESULTS The median EQ-5D Index and VAS scores were 0.65 (0.5-0.75) and 80 (60-90), respectively. The most frequently reported problem was anxiety/depression (67.3%), followed by usual activities (48.6%). The statistical analysis showed that factors significantly associated with more reported problems in at least one EQ-5D dimension (P < .05) were: females, ageing, being unmarried, low income, school studies, living in refugee camps, and villages, unemployment, having chronic diseases or pain, and obesity. It is important to note that participants who responded in November showed more problems compared with December 2020. On the other hand, more problems were reported by participants who were infected, had known affected persons, had no enough information, perceived negative effect of confinement, and indicated having a high infection chance (P < .05). CONCLUSIONS This work provides important evidence on the health status and wellbeing during the COVID-19 confinement in a sample of the Palestinian population, affecting almost all the aspects of the health state and wellbeing. This effect could be minimised by improving the COVID-19 preventive education and monitoring that can play an important role in all health and life aspects among the Palestinian population in facing this pandemic.
Collapse
Affiliation(s)
- Anas Hamdan
- Department of Allied and Applied Medical SciencesFaculty of Medicine and Health SciencesAn‐Najah National UniversityNablusPalestine
| | - Mustafa Ghanim
- Department of Biomedical SciencesFaculty of Medicine and Health SciencesAn‐Najah National UniversityNablusPalestine
| | - Rami Mosleh
- Department of PharmacyFaculty of Medicine and Health SciencesAn‐Najah National UniversityNablusPalestine
| |
Collapse
|
5
|
Gatot C, Shern-En Tan E, Liow MHL, Yongqiang Chen J, Png MA, Tan MH, Howe TS, Bee Koh JS. Higher Charlson Comorbidity Index Increases 90-Day Readmission Rate with Poorer Functional Outcomes in Surgically Treated Hip Fracture Patients. Geriatr Orthop Surg Rehabil 2021; 12:21514593211036252. [PMID: 34422439 PMCID: PMC8371729 DOI: 10.1177/21514593211036252] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/04/2021] [Accepted: 12/07/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction The associated mortality and morbidity in hip fracture patients pose a major
healthcare burden for ageing populations worldwide. We aim to analyse how an
individual’s comorbidity profile based on age-adjusted Charlson Comorbidity
Index (CCI) may impact on functional outcomes and 90-day readmission rates
after hip fracture surgery. Materials and Methods Surgically treated hip fracture patients between 2013 and 2016 were followed
up for 1-year and assessed using Parker Mobility Score (PMS), EuroQol-5D
(EQ-5D) and Physical and Mental Component Scores (PCS and MCS, respectively)
of Short Form-36 (SF-36). Statistical analysis was done by categorising 444
patients into three groups based on their CCI: (1) CCI 0–3, (2) CCI 4–5 and
(3) CCI ≥ 6. Results PMS, EQ-5D and SF-36 PCS were significantly different amongst the CCI groups
pre-operatively and post-operatively at 3, 6 and 12 months (all
P < 0.05), with CCI ≥ 6 predicting for poorer
outcomes. In terms of 90-day readmission rates, patients who have been
readmitted have poorer outcome scores. Multivariate analysis showed that
high CCI scores and 90-day readmission rate both remained independent
predictors of worse outcomes for SF-36 PCS, PMS and EQ-5D. Discussion CCI scores ≥6 predict for higher 90-day readmission rates, poorer quality of
life and show poor potential for functional recovery 1-year post-operation
in hip fracture patients. 90-day readmission rates are also independently
associated with poorer functional outcomes. Peri-operatively, surgical teams
should liaise with medical specialists to optimise patients’ comorbidities
and ensure their comorbidities remain well managed beyond hospital discharge
to reduce readmission rates. With earlier identification of patient groups
at risk of poorer functional outcomes, more planning can be directed towards
appropriate management and subsequent rehabilitation. Conclusion Further research should focus on development of a stratified, peri-operative
multidisciplinary, hip-fracture care pathway treatment regime based on CCI
scores to determine its effectiveness in improving functional outcomes.
Collapse
Affiliation(s)
- Cheryl Gatot
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Evan Shern-En Tan
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | | | - Jerry Yongqiang Chen
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Meng Ai Png
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Mann Hong Tan
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Tet Sen Howe
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Joyce Suang Bee Koh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
6
|
Mok CH, Kwok HHY, Ng CS, Leung GM, Quan J. Health State Utility Values for Type 2 Diabetes and Related Complications in East and Southeast Asia: A Systematic Review and Meta-Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1059-1067. [PMID: 34243830 DOI: 10.1016/j.jval.2020.12.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/18/2020] [Accepted: 12/29/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVES East and Southeast Asia has the greatest burden of diabetes in the world. We sought to derive a reference set of utility values for type 2 diabetes without complication and disutility (utility decrement) values for important diabetes-related complications to better inform economic evaluation. METHODS A systematic review to identify utility values for diabetes and related complications reported in East and Southeast Asia. We searched MEDLINE (OVID) from inception to May 26, 2020 for utility values elicited using direct and indirect methods. Identified studies were assessed for quality based on the National Institute of Health and Care Excellence guidelines. Utility and disutility estimates were pooled by meta-analyses with subgroup analyses to evaluate differences by nationality and valuation instrument. (PROSPERO: CRD42020191075). RESULTS We identified 17 studies for the systematic review from a total of 13 035 studies in the initial search, of which 13 studies met the quality criteria for inclusion in the meta-analyses. The pooled utility value for diabetes without complication was 0.88 (95% CI 0.83-0.93), with the pooled utility decrement for associated complications ranged from 0.00 (for excess BMI) to 0.18 (for amputation). The utility values were consistently more conservative than previous estimates derived in Western populations. Utility decrements were comparable for SF-6D and EQ-5D valuation instruments and for Chinese and other Asian groups. CONCLUSIONS A reference set of pooled disutility and utility values for type 2 diabetes and its complications in East and Southeast Asian populations yielded more conservative estimates than Western populations.
Collapse
Affiliation(s)
- Chiu Hang Mok
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Harley H Y Kwok
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Carmen S Ng
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Gabriel M Leung
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong SAR, China
| | - Jianchao Quan
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
7
|
Burden of visual impairment in mainland China: the Handan Eye Study and Beijing Eye Study. Graefes Arch Clin Exp Ophthalmol 2021; 259:3501-3509. [PMID: 34131787 DOI: 10.1007/s00417-021-05234-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/29/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To determine the impact of visual impairment (VI) on health-related quality of life (HRQoL) and to compare the health burden of VI in different areas in mainland China. METHODS A cohort of 6830 people from rural villages and a cohort of 3251 people from an urban city were included to receive comprehensive ophthalmologic examinations and complete the European Quality of Life-5 Dimensions 3 Levels (EQ-5D-3L) questionnaire. For urban and rural populations, a unified VI grouping standard was adopted: the eyes were classified into normal group, mild-moderate group, and severe group according to WHO standards, and then divided into 6 groups considering both eyes. We estimated the effects of VI on the EQ-5D index score using linear regression models and the association between VI and self-reported EQ-5D health problems using logistic regression models. Associations were assessed by the Spearman correlation coefficient. RESULTS The prevalence of VI and the index scores of EQ-5D-3L for each subgroup of VI were higher for the rural cohort. In these two cohorts, the severity of VI in rural population (Spearman r = 0.205; p < 0.0001) and urban population (Spearman r = 0.164; p < 0.0001) is correlated with the EQ-5D index score. In the rural cohort, the difference in index scores with bilateral severe VI compared to those without VI, after adjusting for covariates, was - 0.053 for the rural cohort and - 0.084 for the urban cohort, respectively. In the rural cohort, the odds ratio for bilateral severe VI was 4.39 for mobility, 6.33 for self-care, and 5.88 for usual activities. The incidence of anxiety or depression and pain or discomfort in the urban cohort was greater; the OR for bilateral severe VI in the urban cohort was 4.75. CONCLUSIONS VI has a negative impact on HRQoL in the rural and urban areas of China, especially in urban population. It is also more likely to cause anxiety or depression among the urban cohort, which deserves special attention.
Collapse
|
8
|
Gupta P, Man REK, Fenwick EK, Aravindhan A, Gan ATL, Thakur S, Soh BLP, Wood JM, Black AA, Chan A, Ng D, Hean TK, Goh E, Mary CFF, Loo J, Forde CG, Sabanayagam C, Cheng CY, Wong TY, Lamoureux EL. Rationale and Methodology of The PopulatION HEalth and Eye Disease PRofile in Elderly Singaporeans Study [PIONEER]. Aging Dis 2020; 11:1444-1458. [PMID: 33269099 PMCID: PMC7673841 DOI: 10.14336/ad.2020.0206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 02/06/2020] [Indexed: 12/23/2022] Open
Abstract
To describe the rationale, design and methodology of a geographically-representative and population-based study investigating the epidemiology, impact, personal and economic burden of age-related eye diseases, declining visual and other sensory systems in Asians aged >60 years in Singapore.PIONEER (The PopulatION HEalth and Eye Disease PRofilE in Elderly Singaporeans Study) is currently a cross-sectional study targeting 3152 Chinese, Malay and Indian adults who are Singapore citizens or permanent residents aged 60 years and older living across Singapore. The study is intended to be longitudinal, with several waves of data planned to be collected in the future. The sampling frame consisted of 7000 names derived from age, gender and ethnicity-stratified random sampling of individuals >60 years. Selected individuals were invited via letters, home visits, and telephone calls for a clinical assessment at the Singapore Eye Research Institute. Individuals with limited mobility were examined in a custom-designed mobile eye clinic. Questionnaires were subsequently administered at participants' homes by trained interviewers in their preferred language. A total of 3,299 participants (from East, West, North and South Singapore) were approached from December 2017 to November 2019. Of these, 953 (28.5%) were deemed ineligible. Out of 2,346 eligible participants, 904 (38.5%) refused, and 1,442 (61.5%) attended our clinical testing protocol, giving an initial response rate of 61.5%. Of these, 1,170 (81%) were cognitively able to complete the questionnaire assessment. The mean age±SD of our participants was 73.8±8.6 years; n=798 (55.3%) were female; and 828 (57.4%) were of Chinese ethnicity. The findings from this study will allow a deeper understanding of the risk factors and impact of aging in Asian populations, particularly in relation to the visual function and other functional system.
Collapse
Affiliation(s)
- Preeti Gupta
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
| | - Ryan Eyn Kidd Man
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
| | - Eva K Fenwick
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
- Duke-NUS Medical School, Singapore.
| | - Amudha Aravindhan
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
| | - Alfred TL Gan
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
| | - Sahil Thakur
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
| | | | - Joanne M Wood
- Queensland University of Technology, Brisbane, Australia.
| | - Alex A Black
- Queensland University of Technology, Brisbane, Australia.
| | | | - David Ng
- Duke-NUS Medical School, Singapore.
| | | | | | | | - Jenny Loo
- National University Hospital, Singapore.
| | - Ciaran Gerard Forde
- Singapore Institute for Clinical Sciences, National University of Singapore, Singapore.
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
- Duke-NUS Medical School, Singapore.
| | - Ching-Yu Cheng
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
- Duke-NUS Medical School, Singapore.
- Department of Ophthalmology, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
- Duke-NUS Medical School, Singapore.
- Department of Ophthalmology, National University of Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
- Duke-NUS Medical School, Singapore.
- Department of Ophthalmology, National University of Singapore, Singapore
| |
Collapse
|
9
|
Młyńczak K, Golicki D. Validity of the EQ-5D-5L questionnaire among the general population of Poland. Qual Life Res 2020; 30:817-829. [PMID: 33099710 PMCID: PMC7952292 DOI: 10.1007/s11136-020-02667-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 01/13/2023]
Abstract
Purpose We aim to compare the psychometric properties of the EQ-5D-5L questionnaire with the EQ-5D-3L version and EQ VAS, based on a survey conducted in a sample representing the general adult population of Poland. Methods The survey comprised health-related quality of life (HRQoL) questionnaires: EQ-5D-5L, EQ VAS, SF-12 and EQ-5D-3L, together with demographic and socio-economic characteristics items. The EQ-5D index values were estimated based on a directly measured value set for Poland. The following psychometric properties were analysed: feasibility, distribution of responses, redistribution from EQ-5D-3L to EQ-5D-5L, inconsistencies, ceiling effects, informativity power and construct validity. We proposed a novel approach to the construct validity assessment, based on the use of a machine learning technique known as the random forest algorithm. Results From March to June 2014, 3978 subjects (aged 18–87, 53.2% female) were surveyed. The EQ-5D-5L questionnaire had a lower ceiling effect compared to EQ-5D-3L (38.0% vs 46.6%). Redistribution from EQ-5D-3L to EQ-5D-5L was similar for each dimension, and the mean inconsistency did not exceed 5%. The results of known-groups validation confirmed the hypothesis concerning the relationship between the EQ-5D index values and age, sex and occurrence of diabetes. Conclusions The EQ-5D-5L, in comparison with its EQ-5D-3L equivalent, showed similar or better psychometric properties within the general population of a country. We assessed the construct validity of the questionnaire with a novel approach that was based on a machine learning technique known as the random forest algorithm.
Collapse
Affiliation(s)
- Katarzyna Młyńczak
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1b Banacha St, 02-097, Warsaw, Poland. .,HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K, Warsaw, Poland.
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1b Banacha St, 02-097, Warsaw, Poland.,HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K, Warsaw, Poland
| |
Collapse
|
10
|
Busija L, Ackerman IN, Haas R, Wallis J, Nolte S, Bentley S, Miura D, Hawkins M, Buchbinder R. Adult Measures of General Health and Health‐Related Quality of Life. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:522-564. [DOI: 10.1002/acr.24216] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - Romi Haas
- Cabrini Institute, Malvern, Victoria, Australia, and Monash University Melbourne Victoria Australia
| | - Jason Wallis
- Cabrini Institute, Malvern, Victoria, Australia, and Monash University Melbourne Victoria Australia
| | - Sandra Nolte
- Charité – Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany, ICON GmbH, Munich, Germany, and Deakin University Burwood Victoria Australia
| | - Sharon Bentley
- Queensland University of Technology Kelvin Grove Queensland Australia
| | | | - Melanie Hawkins
- Deakin University, Burwood, Victoria, Australia, and Swinburne University of Technology Melbourne Victoria Australia
| | - Rachelle Buchbinder
- Cabrini Institute, Malvern, Victoria, Australia, and Monash University Melbourne Victoria Australia
| |
Collapse
|
11
|
Seng JJB, Kwan YH, Fong W, Phang JK, Lui NL, Thumboo J, Leung YY. Validity and reliability of EQ-5D-5L among patients with axial spondyloarthritis in Singapore. Eur J Rheumatol 2020; 7:71-78. [PMID: 32644927 DOI: 10.5152/eurjrheum.2020.19043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 01/11/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the reliability and validity of EuroQOL-5 Dimensions-5 Levels (EQ-5D-5L) among patients with axial spondyloarthritis (SpA) in Singapore. METHODS A cross-sectional study was conducted involving patients with axial SpA in an Asian tertiary hospital from 2017 to 2018. This study followed the COnsensus-based Standards for selection of health Measurement Instruments framework. Construct validity was evaluated by testing 22 a priori hypotheses with other patient-reported outcomes measures. Cronbach's alpha was used to estimate the internal consistency of the EQ-5D-5L, while its test-retest reliability was assessed using weighted kappa and the intraclass correlation coefficient (ICC). The measurement error was assessed by analyzing minimal detectable change (MDC). RESULTS The median age of included patients (n=118) was 35 years (interquartile range: 28, 49). Ninety-six (81.4%) patients were male, while 112 (94.9%) patients were of Chinese ethnicity. The EQ-5D-5L demonstrated good internal consistency with a Cronbach's alpha of 0.79. The test-retest reliability of the EQ-5D-5L was good with a weighted kappa of ≥0.61 for mobility, self-care, usual activities, and anxiety/depression; the ICC was 0.92 and 0.99 for the EQ-5D-5L index and visual analog scale (VAS) scores, respectively. The weighted kappa for the EQ-5D-5L pain/discomfort was moderate [0.53, 95% confidence interval: 0.41-0.60]. The MDC for EQ-5D-5L index and VAS scores was 0.06 and 4.5, respectively. Convergent validity was supported as all hypotheses were confirmed in the results. CONCLUSION This study supports EQ-5D-5L as a valid and reliable instrument for assessing health-related quality of life among patients with axial SpA in Singapore.
Collapse
Affiliation(s)
| | - Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore
| | - Warren Fong
- Department of Medicine, Duke-NUS Medical School, 8 College Road, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore
| | - Nai Lee Lui
- Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore
| | - Ying Ying Leung
- Department of Medicine, Duke-NUS Medical School, 8 College Road, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore
| |
Collapse
|
12
|
Qian X, Tan RLY, Chuang LH, Luo N. Measurement Properties of Commonly Used Generic Preference-Based Measures in East and South-East Asia: A Systematic Review. PHARMACOECONOMICS 2020; 38:159-170. [PMID: 31761995 PMCID: PMC7081654 DOI: 10.1007/s40273-019-00854-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Our aim was to systematically review published evidence on the construct validity, test-retest reliability and responsiveness of generic preference-based measures (PBMs) used in East and South-East Asia. METHODS This systematic review was guided by the COSMIN guideline. A literature search on the MEDLINE, EMBASE, PsycINFO and PubMed databases up to August 2019 was conducted for measurement properties validation papers of the EuroQol-5 Dimensions (EQ-5D), Short Form-6 Dimensions (SF-6D), Health Utilities Index (HUI), Quality of Well-Being (QWB), 15-Dimensional (15D) and Assessment of Quality of Life (AQOL) in East and South-East Asian countries. Included papers were disaggregated into individual studies whose results and quality of design were rated separately. The population-specific measurement properties (construct validity, test-retest reliability and responsiveness) of each PBM were assessed separately using relevant studies. The overall methodological quality of the studies used in each of the assessments was also rated. RESULTS A total of 79 papers containing 1504 studies were included in this systematic review. The methodological quality was 'very good' or 'adequate' for the majority of the construct validity studies (99%) and responsiveness studies (61%), but for only a small portion of the test-retest reliability studies (23%). EQ-5D was most widely assessed and was found to have 'sufficient' construct validity and responsiveness in many populations, while the SF-6D and EuroQol-Visual Analog Scale (EQ-VAS) exhibited 'inconsistent' construct validity in some populations. Scarce evidence was available on HUI and QWB, but current evidence supported the use of HUI. CONCLUSIONS This systematic review provides a summary of the quality of existing generic PBMs in Asian populations. The current evidence supports the use of EQ-5D as the preferred choice when a generic PBM is needed, and continuous testing of all PBMs in the region.
Collapse
Affiliation(s)
- Xinyu Qian
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore
| | - Rachel Lee-Yin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore
| | - Ling-Hsiang Chuang
- Pharmerit International, Marten Meesweg 107, 3068 AV, Rotterdam, The Netherlands
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore.
| |
Collapse
|
13
|
Pitton Rissardo J, Fornari Caprara A. Parkinson’s disease rating scales: a literature review. ANNALS OF MOVEMENT DISORDERS 2020. [DOI: 10.4103/aomd.aomd_33_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
14
|
Wee LE, Sundarajoo M, Quah WF, Farhati A, Huang JY, Chua YY. Health-related quality of life and its association with outcomes of outpatient parenteral antibiotic therapy. Eur J Clin Microbiol Infect Dis 2019; 39:765-772. [PMID: 31873862 DOI: 10.1007/s10096-019-03787-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/02/2019] [Indexed: 01/09/2023]
Abstract
While health-related quality of life (HRQoL) is an important component of patient-centred care, few studies have looked at the association between HRQoL and outcomes while on OPAT. From 2014 to 2017, we conducted a prospective cohort study of all patients referred to Singapore General Hospital's (SGH) OPAT service. At baseline, we collected sociodemographic, clinical, and treatment-related factors for OPAT recipients. We also measured baseline HRQoL using the EuroQoL EQ5D-3 L. We evaluated the association between HRQoL and the following outcomes: complications experienced while on OPAT, early termination requiring readmission during planned course of OPAT, all-cause readmission 30 days after completion of OPAT, and return to work while on OPAT. We used chi-squared test for univariate analysis and cox regression for multivariate analysis. From 2014 to 2017, 1213 patients received OPAT at our centre. Of those, 13.2% (160/1213) developed complications. About 10% (132/1213) of patients were readmitted while on OPAT and OPAT was terminated early. Amongst patients who completed OPAT (N = 1081), about 3.6% (39/1081) were readmitted within 30 days after OPAT completion. About half (50.8%, 278/547) returned to work while on OPAT. On multivariate analysis, patients with perfect health-related quality of life (HRQoL) (adjusted relative risk, aRR = 0.62, 95%CI = 0.45-0.85) were less likely to experience complications, had lower risk of OPAT termination (aRR = 0.57, 95%0.38-0.86), and were more likely to return to work while on OPAT (aRR = 1.94, 95%CI = 1.30-2.89). HRQoL at baseline was significantly associated with lower risk of complications and early OPAT termination, as well as greater likelihood of return to work while on OPAT.
Collapse
Affiliation(s)
- Liang En Wee
- Duke-NUS Graduate Medical School, Singapore, Singapore. .,Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore.
| | | | - Way-Fang Quah
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| | - Ahmad Farhati
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| | - Jie-Ying Huang
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| | - Ying-Ying Chua
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
15
|
Man REK, Gan AHW, Fenwick EK, Gan ATL, Gupta P, Sabanayagam C, Tan N, Wong KH, Wong TY, Cheng CY, Lamoureux EL. Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease. Popul Health Metr 2019; 17:17. [PMID: 31806040 PMCID: PMC6896313 DOI: 10.1186/s12963-019-0197-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/06/2019] [Indexed: 01/08/2023] Open
Abstract
Background To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD). Methods We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2] years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004–2011). Diabetes was defined as random blood glucose ≥ 11.1 mmol/L or HbA1c > 6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ≥ 6.2 mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants’ answers to the questions: “Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?” The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders. Results Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ≤6 years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (all P < 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (all P < 0.05). Conclusions Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD.
Collapse
Affiliation(s)
- Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Alvin Hong Wei Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Alfred Tau Liang Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Nicholas Tan
- National University of Singapore, Singapore, Singapore
| | - Kah Hie Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,National University of Singapore, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore.,National University of Singapore, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore.,National University of Singapore, Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore. .,Duke-NUS Medical School, Singapore, Singapore. .,National University of Singapore, Singapore, Singapore.
| |
Collapse
|
16
|
Impact of pharmaceutical care on mental well-being and perceived health among community-dwelling individuals with type 2 diabetes. Qual Life Res 2019; 28:3273-3279. [PMID: 31359238 DOI: 10.1007/s11136-019-02253-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2019] [Indexed: 02/01/2023]
Abstract
PURPOSE Mental well-being among community-dwelling individuals with type 2 diabetes has not been well established. The primary objective was to evaluate the change in the mental well-being of individuals with diabetes. The secondary objective was to evaluate the association between changes in mental well-being and perceived health over 6 months, and any interacting factors in this association. METHODS This was a prospective, multicenter study. Community-dwelling individuals aged ≥ 21 years with type 2 diabetes were invited to meet with community pharmacists monthly for 6 months. Individuals who were unable to converse independently were excluded. A 12-item General Health Questionnaire (GHQ), measuring mental well-being was administered at baseline, and after 3 and 6 months. Perception of health was measured using the visual analog scale (VAS) of the EuroQoL 5-Dimension tool. Linear mixed model was used to analyze the change in mean GHQ and VAS scores. Association between the changes in GHQ and VAS scores was determined, and moderation analysis was conducted to elucidate the interacting variables of this association. RESULTS Ninety-six individuals (82.4%) were included for analysis. The mean age was 60.3 years with a baseline mean HbA1c of 7.6%. A mean GHQ score reduction of 1.36 (p = 0.022) was observed. This reduction of mean GHQ score was associated with the change in mean VAS score. Having a duration of diabetes diagnosis of < 3.2 years was identified as moderator of this association. CONCLUSION Effective integrated pharmaceutical care with individualized counseling on lifestyle management appeared to improve the mental health of community-dwelling individuals with diabetes on top of glycemic control.
Collapse
|
17
|
Gupta P, Aravindhan A, Gand ATL, Man REK, Fenwick EK, Mitchell P, Tan N, Sabanayagam C, Wong TY, Cheng CY, Lamoureux EL. Association Between the Severity of Diabetic Retinopathy and Falls in an Asian Population With Diabetes: The Singapore Epidemiology of Eye Diseases Study. JAMA Ophthalmol 2019; 135:1410-1416. [PMID: 29145583 DOI: 10.1001/jamaophthalmol.2017.4983] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance The presence and severity of diabetic retinopathy (DR) may contribute to the risk of falling in persons with diabetes, but evidence is currently equivocal. Objective To investigate the associations of diabetes and DR severity with the likelihood of falls in a multiethnic Asian population. Design, Setting, and Participants Cross-sectional post hoc analysis of the Singapore Epidemiology of Eye Diseases study, a population-based study of participants from 3 ethnic groups (3280 Malay, 3400 Indian, and 3353 Chinese individuals) conducted from 2004 to 2011. Of these participants, 552 had data missing on diabetes, falls history, or other covariates or had ungradable fundus photographs and were excluded, leaving 9481 participants. These 9481 underwent a standardized clinical examination and responded to an interviewer-administered questionnaire that collected clinical and sociodemographic information. Multivariable logistic regression models adjusted for confounding fall risk factors assessed the associations of falls with diabetes, DR, and DR severity. A trend analysis was conducted in participants with diabetes to assess if risk of falling was associated with DR severity. Data were analyzed from January 1 through April 30, 2017. Exposures Diabetes was defined as a random glucose level of at least 200 mg/dL, hemoglobin A1c concentration of at least 6.5% of total hemoglobin, self-reported use of diabetic medication, or history of physician-diagnosed diabetes. Severity of DR was graded as none, minimal, mild, moderate, and vision threatening (VT). Main Outcomes and Measures A self-reported fall occurring in the previous 12 months, when the participant fell and landed on the ground. Results Of the 9481 participants with a mean (SD) age of 58.7 (10.3) years (4781 women [50.4%]), 6612 (69.7%) had no diabetes and 2869 (30.3%) had diabetes, of whom 857 (29.9%) had DR in at least 1 eye. A history of falls was reported in 872 (13.2%) without diabetes, 328 (16.3%) with no DR, 44 (14.2%) with minimal DR, 54 (26.2%) with mild DR, 34 (27.2%) with moderate DR, and 43 (19.9%) with VTDR (P for trend < .001). In multivariable models, those with DR were more likely to have fallen (odds ratio [OR], 1.31; 95% CI, 1.07-1.60; P = .008) compared with those with no diabetes; no associations were found for participants without DR compared with those with no diabetes. In addition, compared with participants with diabetes but without DR, those with mild (OR, 1.81; 95% CI, 1.23-2.67; P = .003) and moderate (OR, 1.89; 95% CI, 1.16-3.07; P = .01) nonproliferative DR were more likely to have fallen. Having VTDR was not independently associated with a higher likelihood of falling. Conclusions and Relevance The presence of mild to moderate nonproliferative DR was independently associated with an increased likelihood of falling in persons with diabetes compared with persons with diabetes but without DR. Management strategies for diabetes should incorporate fall education and prevention information, particularly in patients with early-stage DR. Longitudinal studies exploring the association between mild to moderate nonproliferative DR and falling will be required to confirm these findings.
Collapse
Affiliation(s)
- Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Amudha Aravindhan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Alfred T L Gand
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Medical School, Singapore
| | - Paul Mitchell
- Department of Ophthalmology, The University of Sydney, Australia
| | - Nicholas Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Medical School, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Medical School, Singapore,Department of Ophthalmology, National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Medical School, Singapore,Department of Ophthalmology, National University of Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore,Duke-NUS Medical School, Singapore
| |
Collapse
|
18
|
Yeoh YS, Koh GCH, Tan CS, Tu TM, Singh R, Chang HM, De Silva DA, Ng YS, Ang YH, Yap P, Chew E, Merchant RA, Yeo TT, Chou N, Venketasubramanian N, Lee KE, Young SH, Hoenig H, Matchar DB, Luo N. Health-related quality of life loss associated with first-time stroke. PLoS One 2019; 14:e0211493. [PMID: 30689666 PMCID: PMC6349359 DOI: 10.1371/journal.pone.0211493] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/15/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study aimed to quantify health-related quality of life (HRQoL) loss associated with first episode of stroke by comparing patient-reported HRQoL before and after stroke onset. The impact of stroke in local population was also evaluated by comparing the pre- and post-stroke HRQoL with that of the general population. METHODS The HRQoL of stroke survivors was assessed with the EQ-5D-3L index score at recruitment, for recalled pre-stroke HRQoL, and at 3 and 12 month post-stroke. Change in HRQoL from pre-stroke to 3 and 12 month was self-reported by 285 and 238 patients, respectively. Mean EQ index score at each time point (baseline: 464 patients; 3 month post-stroke: 306 patients; 12 month post-stroke: 258 patients) was compared with published population norms for EQ-5D-3L. RESULTS There was a significant decrease in HRQoL at 3 (0.25) and 12 month (0.09) post-stroke when compared to the retrospectively recalled patients' mean pre-stroke HRQoL level (0.87). The reduction at 3 month was associated with the reduction in all EQ-5D-3L health dimensions; reductions remaining at 12 month were limited to dimensions of mobility, self-care, usual activities, and anxiety/depression. Stroke patients had a lower mean EQ index than the general population by 0.07 points pre-stroke (0.87 vs. 0.94), 0.33 points at 3 month (0.61 vs. 0.94) and 0.18 points at 12 month (0.76 vs. 0.94) post-stroke. CONCLUSIONS Stroke has a substantial impact on HRQoL in Singapore, especially in the first three months post-stroke. Compared to the general population, stroke survivors have lower HRQoL even before stroke onset. This pre-stroke deficit in HRQoL should be taken into account when quantifying health burden of stroke or setting goals for stroke rehabilitation.
Collapse
Affiliation(s)
- Yen Shing Yeoh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Tian Ming Tu
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Rajinder Singh
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Hui Meng Chang
- Department of Neurology, Singapore General Hospital campus, National Neuroscience Institute, Singapore, Singapore
| | - Deidre A. De Silva
- Department of Neurology, Singapore General Hospital campus, National Neuroscience Institute, Singapore, Singapore
| | - Yee Sien Ng
- Department of Rehabilitation Medicine, Singapore General Hospital, Singapore, Singapore
| | - Yan Hoon Ang
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Philip Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Effie Chew
- Department of Rehabilitation Medicine, National University Hospital, Singapore, Singapore
| | - Reshma A. Merchant
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tseng Tsai Yeo
- Department of Neurosurgery, National University Hospital, Singapore, Singapore
| | - Ning Chou
- Department of Neurosurgery, National University Hospital, Singapore, Singapore
| | | | - Kim En Lee
- Farrer Park Medical Centre, Farrer Park Hospital, Singapore, Singapore
| | - Sherry H. Young
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore, Singapore
| | - Helen Hoenig
- Physical Medicine & Rehabilitation Service, Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - David Bruce Matchar
- Health Services & Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
- Center for Clinical Health Policy Research, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| |
Collapse
|
19
|
Erh BXY, He HG, Carter KF, Cheung PP, Tan DS, Wang W, Rome K. Validation of the Chinese Manchester foot pain and disability index (C-MFPDI) among patients with inflammatory arthritis. J Foot Ankle Res 2019; 12:6. [PMID: 30679958 PMCID: PMC6343242 DOI: 10.1186/s13047-019-0316-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/14/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The Manchester Foot Pain and Disability Index (MFPDI) is a patient-reported outcome tool used to measure foot pain and foot-related disability. The English version of the MFPDI has been successfully translated into other European languages, but there was no Chinese version to use in Chinese-speaking communities. The cross-sectional correlational study aimed to translate the MFPDI from English into simplified Chinese (C-MFPDI) and to test its psychometric properties among people with inflammatory arthritis in Singapore. METHODS The MFPDI was translated from English into Chinese using a forward-backward translation framework and was administered to 100 Chinese-speaking people with inflammatory arthritis. From the original 100 participants, 30 participants re-evaluated the C-MFPDI after 2 weeks. A Visual Analogue Scale and the Taiwan Chinese Foot Function Index in simplified Chinese were used to evaluate concurrent validity with the C-MFPDI. Health-related quality of life was assessed using the Chinese version of the European Quality of Life-5 Dimension to test construct validity. RESULTS The C-MFPDI had a high translation equivalent rate (96.3%) and content validity index (0.92), good internal consistency (Cronbach's α = 0.90) and test-retest reliability (ICC = 0.87). The concurrent validity of the C-MFPDI was demonstrated to be acceptable through its significantly moderate to strong positive correlations with the Taiwan Chinese Foot Function Index (r = 0.62-0.72, p < 0.01) and Visual Analogue Scale foot pain (r = 0.65, p < 0.01). The C-MFPDI total scores were moderately negatively associated with Chinese European Quality of Life-5 Dimension utility scores (r = - 0.40, p < 0.01). CONCLUSION The C-MFPDI had good psychometric properties. The C-MFPDI can be used to assess disabling foot pain, impairment and disability in Chinese-speaking people with inflammatory arthritis.
Collapse
Affiliation(s)
- Brina Xing Ying Erh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre Bock MD11, 10 Medical Drive, Singapore, 117597 Singapore
- Division of Nursing, National University Hospital, Singapore, Singapore
| | - Hong-gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre Bock MD11, 10 Medical Drive, Singapore, 117597 Singapore
- National University Health System, Singapore, Singapore
| | - Kate Frances Carter
- National University Health System, Singapore, Singapore
- Podiatry Department, Rehabilitation Centre, National University Hospital, Singapore, Singapore
- Podiatry Division, School of Health and Science, Western Sydney University, Sydney, Australia
| | - Peter P. Cheung
- National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Rheumatology, National University Hospital, Singapore, Singapore
| | - Daphne S. Tan
- National University Health System, Singapore, Singapore
- Podiatry Department, Rehabilitation Centre, National University Hospital, Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre Bock MD11, 10 Medical Drive, Singapore, 117597 Singapore
- National University Health System, Singapore, Singapore
| | - Keith Rome
- Podiatry, Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
20
|
Ge L, Ong R, Yap CW, Heng BH. Effects of chronic diseases on health-related quality of life and self-rated health among three adult age groups. Nurs Health Sci 2018; 21:214-222. [PMID: 30537214 DOI: 10.1111/nhs.12585] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/17/2018] [Accepted: 10/24/2018] [Indexed: 12/21/2022]
Abstract
Little is known about whether there is any difference in associations of chronic diseases with health-related quality of life and self-rated health across age groups. The purpose of the present study was to examine the associations of one specific and multiple chronic diseases with health-related quality of life and self-rated health (measured using the 5-level EQ-5D version) in three age groups: young (21-44 years), middle-aged (45-64 years), and older adults (≥65 years). Secondary data analysis of 1932 participants in the Population Health Index Survey was performed. Linear regression results showed that different chronic diseases had a characteristic effect on health-related quality of life and self-rated health among different age groups. The presence of a single chronic disease was associated with lower health-related quality of life and self-rated health in young adults. Multi-morbidity was consistently associated with decreased health-related quality of life and self-rated health in all age groups. Our findings suggest that although young adults have a lower prevalence of chronic diseases, their impacts on health-related quality of life and self-rated health can be as significant as that in middle-aged and older adults.
Collapse
Affiliation(s)
- Lixia Ge
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Reuben Ong
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Chun Wei Yap
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Bee Hoon Heng
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| |
Collapse
|
21
|
Min Ho PY, Hu W, Lee YY, Gao C, Tan YZ, Cheen HH, Wee HL, Lim TG, Ong WC. Health-related quality of life of patients with inflammatory bowel disease in Singapore. Intest Res 2018; 17:107-118. [PMID: 30419638 PMCID: PMC6361019 DOI: 10.5217/ir.2018.00099] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/04/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/AIMS Inflammatory bowel disease (IBD) is associated with considerable impairment of patients' health-related quality of life (HRQoL). Knowledge of factors that significantly affect IBD patients' HRQoL can contribute to better patient care. However, the HRQoL of IBD patients in non-Western countries are limited. Hence, we assessed the HRQoL of Singaporean IBD patients and identified its determinants. METHODS A prospective, cross-sectional study was conducted at Singapore General Hospital outpatient IBD Centre. The HRQoL of IBD patients was assessed using the short IBD questionnaire (SIBDQ), Short Form-36 physical and mental component summary (SF-36 PCS/MCS) and EuroQol 5-dimensions 3-levels (EQ-5D-3L) and visual analogue scale (VAS). Independent samples t-test was used to compare HRQoL between Crohn's disease (CD) and ulcerative colitis (UC). Determinants of HRQoL were identified through multiple linear regression. RESULTS A total of 195 IBD patients (103 UC, 92 CD) with a mean disease duration of 11.2 years were included. There was no significant difference in HRQoL between patients with UC and CD. Factors that significantly worsened HRQoL were presence of active disease (b=-6.293 [SIBDQ], -9.409 [PCS], -9.743 [MCS], -7.254 [VAS]), corticosteroids use (b=-7.392 [SIBDQ], -10.390 [PCS], -8.827 [MCS]), poor medication adherence (b=-4.049 [SIBDQ], -1.320 [MCS], -8.961 [VAS]), presence of extraintestinal manifestations (b=-13.381 [PCS]), comorbidities (b=-4.531 [PCS]), non-employment (b=-9.738 [MCS], -0.104 [EQ-5D-3L]) and public housing (b=-8.070 [PCS], -9.207 [VAS]). CONCLUSIONS The HRQoL is impaired in this Asian cohort of IBD. The magnitude of HRQoL impairment was similar in UC and CD. Clinical characteristics were better determinants of patients' HRQoL than socio-demographic factors. Recognizing the factors that impact patients' HRQoL would improve the holistic management of IBD patients.
Collapse
Affiliation(s)
- Prisca Yue Min Ho
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Wenjia Hu
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Ying Yun Lee
- Department of Pharmacy, Woodlands Health Campus, Singapore
| | - Chuxi Gao
- Department of Pharmacy, Singapore General Hospital, Singapore
| | - Yan Zhi Tan
- Department of Pharmacy, Singapore General Hospital, Singapore
| | - Hua Heng Cheen
- Department of Pharmacy, Singapore General Hospital, Singapore
| | - Hwee Lin Wee
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Teong Guan Lim
- Department of Pharmacy, Singapore General Hospital, Singapore
| | - Wan Chee Ong
- Department of Pharmacy, Singapore General Hospital, Singapore
| |
Collapse
|
22
|
Ataoğlu S, Ankaralı H, Ankaralı S, Ataoğlu BB, Ölmez SB. Quality of life in fibromyalgia, osteoarthritis and rheumatoid arthritis patients: Comparison of different scales. EGYPTIAN RHEUMATOLOGIST 2018. [DOI: 10.1016/j.ejr.2017.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
23
|
Buchholz I, Janssen MF, Kohlmann T, Feng YS. A Systematic Review of Studies Comparing the Measurement Properties of the Three-Level and Five-Level Versions of the EQ-5D. PHARMACOECONOMICS 2018; 36:645-661. [PMID: 29572719 PMCID: PMC5954044 DOI: 10.1007/s40273-018-0642-5] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND Since the introduction of the five-level version of the EQ-5D (5L), many studies have comparatively investigated the measurement properties of the original three-level version (3L) with the 5L version. OBJECTIVE The aim of this study was to consolidate the available evidence on the performance of both instruments. METHODS A systematic literature search of studies in the English and German languages was conducted (2007-January 2018) using the PubMed, EMBASE, and PsycINFO (EBSCO) databases, as well as the EuroQol Research Foundation website. Data were extracted and assessed on missing values, distributional properties, informativity indices (Shannon's H' and J'), inconsistencies, responsiveness, and test-retest reliability. RESULTS Twenty-four studies were included in the review. Missing values and floor effects (percentage reporting the worst health state) were found to be negligible for both 3L and 5L (< 5%). From 18 studies, inconsistencies ranged from 0 to 10.6%, although they were generally well below 5%, with 9 studies reporting the most inconsistencies for Usual Activities (mean percentage 4.1%). Shannon's indices were always higher for 5L than for 3L, and all but three studies reported lower ceiling effects ('11111') for 5L than for 3L. There is mixed and insufficient evidence on responsiveness and test-retest reliability, although results on index values showed better performance for 5L on test-retest reliability. CONCLUSION Overall, studies showed similar or better measurement properties of the 5L compared with the 3L, and evidence indicated moderately better distributional parameters and substantial improvement in informativity for the 5L compared with the 3L. Insufficient evidence on responsiveness and test-retest reliability implies further research is needed.
Collapse
Affiliation(s)
- Ines Buchholz
- Institute for Community Medicine, University Medicine of Greifswald, Greifswald, Germany.
| | - Mathieu F Janssen
- Department of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
| | - Thomas Kohlmann
- Institute for Community Medicine, University Medicine of Greifswald, Greifswald, Germany
| | - You-Shan Feng
- Institute for Community Medicine, University Medicine of Greifswald, Greifswald, Germany
| |
Collapse
|
24
|
Tay FHE, Thompson CL, Nieh CM, Nieh CC, Koh HM, Tan JJC, Yap PLK. Person-centered care for older people with dementia in the acute hospital. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2017; 4:19-27. [PMID: 29955648 PMCID: PMC6021231 DOI: 10.1016/j.trci.2017.11.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Patients with dementia (PWDs) are often subjected to enforced dependency and experience functional decline and emotional distress during hospital stay. Person-centered care (PCC) with specialized psychosocial interventions, minimally obtrusive medical care, and physical restraints-free practice holds potential to improve patient outcomes. We evaluate the effectiveness of an acute hospital dementia unit (Care for Acute Mentally Infirm Elders [CAMIE]) that adopts a PCC protocol. METHODS Prospective naturalistic cohort study whereby PWDs in the CAMIE unit (n = 170) were compared with a control group in usual care wards (n = 60) over 6 months. Assessments included patient demographics, dementia type and stage, comorbidities (Charlson's Comorbidity Index), acute illness severity, Well-Being, Ill-Being, functional status (Modified Barthel Index), agitation levels (Pittsburgh Agitation Scale), and quality of life (EuroQoL), assessed on admission and discharge. Multivariate analysis of covariance examined the effect of CAMIE versus usual care on pre-post outcomes. RESULTS CAMIE patients showed statistically significant greater gains in Modified Barthel Index function and Well-Being, decreased Ill-Being and agitation, and greater improvement in EuroQoL index score (effect size: Δ = 0.18) after adjusting for baseline differences that translated to a quality-adjusted life years gain of 0.045, assuming stability over 3 months. Estimating added cost of CAMIE stay over usual care at SGD 1500 (USD 1040) for average length of stay of 15 days per patient, the incremental cost-effectiveness ratio fell within the threshold for cost-effectiveness at USD 23,111. DISCUSSION PCC for PWDs in acute hospitals not only improves clinical outcomes for patients but is also cost-effective. The results support the adoption of PCC on a wider scale for better care of PWDs.
Collapse
Affiliation(s)
- Felicia Hui En Tay
- Khoo Teck Puat-National University Children's Medical Institute, Paediatric Medicine, Singapore
- James Cook University, College of Healthcare Sciences, Singapore
| | - Claire L. Thompson
- School of Psychology, The Cairnmillar Institute, Melbourne, Australia
- James Cook University, College of Healthcare Sciences, Townsville, Australia
| | - Chih Ming Nieh
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Chih Chiang Nieh
- Department of Anatomy, National University of Singapore Yong Loo Lin School of Medicine, Singapore
| | - Hui Mien Koh
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | | | - Philip Lin Kiat Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
- Geriatric Education and Research Institute, Singapore
| |
Collapse
|
25
|
Man REK, Charumathi S, Gan ATL, Fenwick EK, Tey CS, Chua J, Wong TY, Cheng CY, Lamoureux EL. Cumulative incidence and risk factors of prediabetes and type 2 diabetes in a Singaporean Malay cohort. Diabetes Res Clin Pract 2017; 127:163-171. [PMID: 28371687 DOI: 10.1016/j.diabres.2017.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/07/2017] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
AIMS The aim of this work was to determine the cumulative incidence and independent risk factors of prediabetes and type 2 diabetes (T2DM) in a well-characterized cohort of Malays in Singapore. METHODS We included 1137 participants (mean age [SD]: 55 (10) years; 53.6% female) without diabetes (DM) at baseline from the Singapore Malay Eye Study, a population-based longitudinal study with baseline (2004-2006), and follow-up (2010-2013) examinations. Prediabetes was defined as an HbA1c between 5.7% and 6.4%, with no self-reported DM history or insulin/DM medication use. T2DM was defined as a random glucose level ≥200mg/dL or HbA1c>6.4% or use of insulin/DM medication. Age-standardized cumulative incidence was calculated as the crude 6-year cumulative incidence standardized to Singapore's Malay population census. Multivariable modified poisson regression models were utilized to determine the risk factors of incident prediabetes and T2DM. RESULTS The age-standardized 6-year cumulative incidence was 11.2% (95% CI 9.5, 13.1%) for T2DM, and 20.4% (95% CI 16.4, 25.2%) for prediabetes. Hypertension, higher body mass index (BMI) and higher Hba1c levels were associated with increased risk of T2DM, while older age and higher high density lipoprotein (HDL) cholesterol were protective (all P<0.05). Only higher BMI and HbA1c levels were independently associated with incident prediabetes (all P≤0.001). CONCLUSIONS While only one in ten adult Malays developed T2DM over 6-years, one in five developed prediabetes over the same time period. Our results suggest that evidence-based interventions addressing modifiable risk factors (obesity, prediabetes, hypertension, low HDL cholesterol) are needed to delay or prevent their onset.
Collapse
Affiliation(s)
- Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Sabanayagam Charumathi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School, Singapore
| | | | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School, Singapore; Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
| | - Ching Siong Tey
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School, Singapore
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School, Singapore; Singapore National Eye Centre, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School, Singapore; Singapore National Eye Centre, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School, Singapore.
| |
Collapse
|
26
|
Man REK, Veerappan AR, Tan SP, Fenwick EK, Sabanayagam C, Chua J, Leong YY, Wong TY, Lamoureux EL, Cheng CY, Tong L. Incidence and risk factors of symptomatic dry eye disease in Asian Malays from the Singapore Malay Eye Study. Ocul Surf 2017; 15:742-748. [PMID: 28442380 DOI: 10.1016/j.jtos.2017.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 03/07/2017] [Accepted: 04/20/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the incidence of symptomatic dry eye disease (SDED) and associated risk factors in a well-characterized cohort of ethnic Malays in Singapore. METHODS We included 1682 participants (mean age [SD]: 57 [10]years; 55.4% female) without SDED from the Singapore Malay Eye Study (SiMES), a population-based longitudinal study with baseline examination (SiMES-1) conducted between 2004 and 2006, and follow-up examination (SiMES-2) conducted between 2010 and 2013. SDED was considered to be present if a participant answered "often" or "all the time" to any of the six questions from the Salisbury Eye Evaluation Study dry eye questionnaire. Age-standardized incidence of SDED was calculated as the crude 6-year cumulative incidence standardized to Singapore's population census. Gender-stratified multivariable log-binomial regression models were utilized to determine the independent risk factors of incident SDED. RESULTS At the 6-year follow-up, 86 of 1682 participants had developed SDED, which was equivalent to an age-standardized 6-year incidence of 5.1% (95% CI 4.1-6.4%). There were no differences in the incidence of SDED between men and women (P = 0.9). Multivariable models revealed that presence of glaucoma and poorer self-rated health were independently associated with incident SDED in men (P = 0.003 and 0.03, respectively), while contact lens wear (P = 0.002), history of thyroid disease (P = 0.03), and having had cataract surgery (P = 0.02) were predictive of incident SDED in women. CONCLUSION One in twenty adult Malays developed SDED over a 6-year period. Risk factors for incident SDED were different between men and women. Future studies and public health interventions should consider this gender-specific difference in risk factors.
Collapse
Affiliation(s)
| | | | | | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore; Centre for Eye Research Australia, University of Melbourne, Australia; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore National Eye Center, Singapore
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Yuan-Yuh Leong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore National Eye Center, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore National Eye Center, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore National Eye Center, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore
| | - Louis Tong
- Singapore Eye Research Institute, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore National Eye Center, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore.
| |
Collapse
|
27
|
Quah JHM, Wang P, Ng RRG, Luo N, Tan NC. Health-related quality of life of older Asian patients with multimorbidity in primary care in a developed nation. Geriatr Gerontol Int 2016; 17:1429-1437. [PMID: 27576513 DOI: 10.1111/ggi.12881] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 06/23/2016] [Accepted: 06/30/2016] [Indexed: 12/21/2022]
Abstract
AIM Older adults are susceptible to two or more chronic ailments or multimorbidity. The present study aimed to establish the relationship between multimorbidity and health-related quality of life (HRQoL) amongst Asian elderly patients in primary care in a developed nation. It also assessed how functional disability and chronic musculoskeletal pain are associated with HRQoL. METHODS A cross-sectional study was carried out in a Singapore public primary care clinic. An interviewer-administered questionnaire was used to collect data on chronic disease profile, HRQoL (using the European Quality of Life 5 Dimension), basic activities of daily living, instrumental activities of daily living, musculoskeletal pain and sociodemographic characteristics. The association of multimorbidity, functional disability and chronic musculoskeletal pain with HRQoL was assessed using multivariate linear regression analysis. RESULTS A total of 498 outpatients aged 65 years and older with multimorbidity were enrolled. Their mean age was 73.9 years, and approximately 75% had between two and four chronic conditions. The most commonly reported chronic conditions were hypertension (86.1%), hyperlipidemia (80.7%), diabetes (40.2%) and arthritis (33.3%). The European Quality of Life 5 Dimension index score decreased significantly when the number of comorbidities was more than five. Chronic hip and knee pain, one or more "dependent" activities of daily living dimensions and two or more "dependent" IADL dimensions were independently associated with worse HRQoL. CONCLUSIONS Multimorbidity is associated with poorer HRQoL amongst older adults in Singapore. Review of chronic musculoskeletal pain and functional disabilities should be integrated into the comprehensive assessment of older adults in an enhanced model of primary care to improve the HRQoL of these older patients. Geriatr Gerontol Int 2017; 17: 1429-1437.
Collapse
Affiliation(s)
| | - Pei Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | |
Collapse
|
28
|
Machado Escobar MA, Yacuzzi MS, Martinez RN, González Lucero L, Bellomio VI, Santana M, Galindo L, Mayer MM, Barreira JC, Sarano J, Gomez G, Collado MV, Martinez A, Orozco MC, Betancur G, Dal Pra F, Sanchez A, Juarez V, Lucero EV. Validation of an Argentine version of Lupus Quality of Life questionnaire. Lupus 2016; 25:1615-1622. [PMID: 27444335 DOI: 10.1177/0961203316660202] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/28/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine reproducibility and validity of an Argentine version of the Lupus Quality of Life questionnaire (LupusQoL) and to determine cut-off values in the questionnaire. MATERIALS AND METHODS One hundred and forty-seven systemic lupus erythematosus patients (American College of Rheumatology 1982/1997) were assessed from April 2014 to July 2014. Demographic and socioeconomic variables were collected, as well as SELENA/SLEDAI, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index Score, comorbidities and treatment data. Patients completed LupusQoL-Argentine version and European Quality of Life Questionnaire (EuroQoL-5D). Internal consistency and reliability were examined. Convergent validity with EuroQoL-5D was assessed through analysis of latent classes, which established homogeneous categories from the responses of each domain of LupusQoL and for the total. RESULTS Out of 147 patients, 93.2% were female, mean age 36.4 ± 11.1 years, mean disease duration 2.7 ± 9 years, mean SELENA/SLEDAI 2.7 ± 3 points. The cut-off point that defined good or bad quality of life was 0.739 for EuroQoL 5D and 63 for LupusQoL. Cut-off values for each LupusQoL domain were also defined, creating two classes in each of them. There was moderate to high concordance to classify quality of life (Kappa = 0.74, 95% confidence interval = 0.54, 0.95). CONCLUSION The Argentine version of LupusQoL is a valid, reliable and reproducible instrument to assess quality of life. In this study, cut-off points that allow the classification of patients regarding whether they have good or bad quality of life are established for the first time.
Collapse
Affiliation(s)
| | - M S Yacuzzi
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
| | | | | | | | - M Santana
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
| | - L Galindo
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
| | - M M Mayer
- Hospital Británico de Buenos Aires, Argentina
| | | | - J Sarano
- Instituto Lanari, Buenos Aires, Argentina
| | - G Gomez
- Instituto Lanari, Buenos Aires, Argentina
| | | | - A Martinez
- Hospital de Agudos Dr E Tornú, Buenos Aires, Argentina
| | - M C Orozco
- Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - G Betancur
- Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - F Dal Pra
- Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | | | | | - E V Lucero
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
| |
Collapse
|
29
|
Wee HL, Seng BJJ, Lee JJ, Chong KJ, Tyagi P, Vathsala A, How P. Association of anemia and mineral and bone disorder with health-related quality of life in Asian pre-dialysis patients. Health Qual Life Outcomes 2016; 14:94. [PMID: 27342630 PMCID: PMC4919845 DOI: 10.1186/s12955-016-0477-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 04/30/2016] [Indexed: 01/28/2023] Open
Abstract
Background Patients with chronic kidney disease (CKD) have poor health-related quality of life (HRQoL). The association of CKD-related complications such as anemia and mineral and bone disorders (MBD) with HRQoL in pre-dialysis patients is not well-studied. As such, this study aimed to determine the association of anemia and MBD with HRQoL in pre-dialysis patients. Methods This was a cross-sectional study involving 311 adult pre-dialysis patients with stage 3–5 CKD from an acute-care hospital in Singapore. Patients’ HRQoL were assessed using Kidney Disease Quality of Life Short Form (KDQOL-SF™) and EuroQol 5 Dimensions–3 levels (EQ5D-3L). HRQoL between patients with and without anemia or MBD were compared by separate hierarchical multiple linear regression analyses using various HRQoL scales as dependent variables, adjusted for sociodemographic, clinical and psychosocial variables. Results After adjusting for MBD, anemia was associated with lower HRQoL scores on work status (WS), physical functioning (PF) and role physical [β (SE): −10.9 (4.18), p = 0.010; −3.0 (1.28), p = 0.018; and −4.2 (1.40), p = 0.003, respectively]. However, significance was lost after adjustments for sociodemographic variables. Patients with MBD had poorer HRQoL with respect to burden of kidney disease, WS, PF and general health [(β (SE): −7.9 (3.88), p = 0.042; −9.5 (3.99), p = 0.018; −3.0 (1.22) p = 0.014; −3.6 (1.48), p = 0.015, respectively]. Although these remained significant after adjusting for sociodemographic variables, significance was lost after adjusting for clinical variables, particularly pill burden. This is of clinical importance due to the high pill burden of CKD patients, especially from medications for the management of multiple comorbidities such as cardiovascular and mineral and bone diseases. Conclusions Neither anemia nor MBD was associated with HRQoL in our pre-dialysis patients. Instead, higher total daily pill burden was associated with worse HRQoL. Medication reconciliation should therefore be routinely performed by clinicians and pharmacists to reduce total daily pill burden where possible.
Collapse
Affiliation(s)
- Hwee-Lin Wee
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, Singapore, 117543, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Benjamin Jun Jie Seng
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Jia Jia Lee
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Kok Joon Chong
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Pallavi Tyagi
- Department of Medicine (Division of Nephrology), National University Hospital, Singapore, Singapore
| | - Anantharaman Vathsala
- Department of Medicine (Division of Nephrology), National University Hospital, Singapore, Singapore
| | - Priscilla How
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, Singapore, 117543, Singapore. .,Department of Medicine (Division of Nephrology), National University Hospital, Singapore, Singapore.
| |
Collapse
|
30
|
Jung JW, Choi JC, Shin JW, Kim JY, Choi BW, Park IW. Pulmonary Impairment in Tuberculosis Survivors: The Korean National Health and Nutrition Examination Survey 2008-2012. PLoS One 2015; 10:e0141230. [PMID: 26496500 PMCID: PMC4619744 DOI: 10.1371/journal.pone.0141230] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 10/06/2015] [Indexed: 12/28/2022] Open
Abstract
Objectives Pulmonary tuberculosis (TB) can affect lung function, but studies regarding long-term follow-up in patients with no sequelae on chest X-ray (CXR) have not been performed. We evaluated lung functional impairment and persistent respiratory symptoms in those with prior pulmonary TB and those with prior pulmonary TB with no residual sequelae on CXR, and determined risk factors for airflow obstruction. Methods We used data from adults aged ≥ 40 years from the annual Korean National Health and Nutrition Examination Surveys conducted between 2008 and 2012. P values for comparisons were adjusted for age, sex, and smoking status. Results In total of 14,967 adults, 822 subjects (5.5%) had diagnosed and treated pulmonary TB (mean 29.0 years ago). The FVC% (84.9 vs. 92.6), FEV1% (83.4 vs. 92.4), and FEV1/FVC% (73.4 vs. 77.9) were significantly decreased in subjects with prior pulmonary TB compared to those without (p < 0.001, each). In 12,885 subjects with no sequalae on CXR, those with prior pulmonary TB (296, 2.3%) had significantly lower FEV1% (90.9 vs. 93.4, p = 0.001) and FEV1/FVC% (76.6 vs. 78.4, p < 0.001) than those without. Subjects with prior pulmonary TB as well as subjects with no sequalae on CXR were more likely to experience cough and physical activity limitations due to pulmonary symptoms than those without prior pulmonary TB (p < 0.001, each). In total subjects, prior pulmonary TB (OR, 2.314; 95% CI, 1.922–2.785), along with age, male, asthma, and smoking mount was risk factor for airflow obstruction. In subjects with prior pulmonary tuberculosis, inactive TB lesion on chest x-ray (OR, 2.300; 95% CI, 1.606–3.294) were risk factors of airflow obstruction. Conclusion In addition to subjects with inactive TB lesion on CXR, subjects with no sequelae on CXR can show impaired pulmonary function and respiratory symptoms. Prior TB is a risk factor for airflow obstruction and that the risk is more important when they have inactive lesions on chest X-ray. Hence, the patients with treated TB should need to have regular follow-up of lung function and stop smoking for early detection and prevention of the chronic airway disease.
Collapse
Affiliation(s)
- Jae-Woo Jung
- Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae-Chol Choi
- Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jong-Wook Shin
- Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae-Yeol Kim
- Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Byoung-Whui Choi
- Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - In-Won Park
- Department of Internal medicine, Chung-Ang University College of Medicine, Seoul, Korea
- * E-mail:
| |
Collapse
|
31
|
Nap A, van Loon A, Peen J, van Schaik DJ, Beekman AT, Dekker JJ. The influence of acculturation on mental health and specialized mental healthcare for non-western migrants. Int J Soc Psychiatry 2015; 61:530-8. [PMID: 25488952 DOI: 10.1177/0020764014561307] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The level of acculturation of migrants varies and is associated with variations in mental health. However, this association is complex and may differ among migrant groups. AIM The aim of this study is to explore the association between acculturation, mental health and treatment effect. METHODS In a longitudinal cohort study of patients treated in specialized mental health facilities, different dimensions of acculturation (skills, social integration, traditions, norms/values and feelings of loss) were explored for Moroccan, Turkish and Surinamese migrants in the Netherlands. Furthermore, the associations between acculturation status and symptom levels, quality of life, care needs and effects of mental health treatment were examined. Data were analyzed with analysis of covariance, correlation analysis and multiple regression analysis. RESULTS Acculturation status differed among migrant groups. Turkish migrants showed most original culture maintenance (traditions, norms/values), Surinamese migrants showed most participation in Dutch society (skills, social integration), while Moroccan migrants were situated in between. Higher cultural adaptation was associated with less need for care, lower symptom levels and a higher quality of life. Participation significantly predicted lower symptom levels (p < .001) and higher quality of life (p < .001) 6 months after the start of treatment. CONCLUSION This study confirms that acculturation status is associated with symptom levels, quality of life and perceived need for care of migrants. Moreover, participation in Dutch society appears to be a favorable factor for treatment effect. It is of importance for professionals in clinical practice to be attentive to this.
Collapse
Affiliation(s)
- Annelies Nap
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
| | | | - Jaap Peen
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
| | - Digna Jf van Schaik
- Research Department, GGZinGeest, Amsterdam, The Netherlands Department of Psychiatry, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Aartjan Tf Beekman
- Research Department, GGZinGeest, Amsterdam, The Netherlands Department of Psychiatry, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jack Jm Dekker
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
| |
Collapse
|
32
|
Wan SW, He HG, Mak A, Lahiri M, Luo N, Cheung PP, Wang W. Health-related quality of life and its predictors among patients with rheumatoid arthritis. Appl Nurs Res 2015; 30:176-83. [PMID: 27091275 DOI: 10.1016/j.apnr.2015.07.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 07/19/2015] [Accepted: 07/31/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Limited studies have examined the predictors of HRQoL among patients with rheumatoid arthritis. This study helped to ascertain the predictors of HRQoL from the pool of influencing factors identified by previous studies. AIM This study investigated the health-related quality of life (HRQoL) of adult patients with rheumatoid arthritis and its predictors. METHODS Using a descriptive correlational design, this study explored the relationship between HRQoL and pain, functional disability, anxiety, depression, medication adherence and social support. Eligible outpatients (n=108) were recruited via their attending doctors who were co-investigators of this study. Informed consent forms were distributed and questionnaires administered in a teaching hub by the main researcher. RESULTS Significant correlations were found between HRQoL and all of the study variables. Pain, functional disability and depression were main predictors of HRQoL. CONCLUSIONS Future evidence-based interventions focusing on pain relief, delaying disability or improving functional ability and reducing depressive symptoms are required to enhance the HRQoL of patients with rheumatoid arthritis.
Collapse
Affiliation(s)
- Su Wei Wan
- Division of Nursing, National University Hospital, Singapore.
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Anselm Mak
- Division of Rheumatology, National University Hospital, Singapore.
| | - Manjari Lahiri
- Division of Rheumatology, National University Hospital, Singapore.
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Peter P Cheung
- Division of Rheumatology, National University Hospital, Singapore.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| |
Collapse
|
33
|
Psychometric properties of the EQ-5D-5L in Thai patients with chronic diseases. Qual Life Res 2015; 24:3015-22. [PMID: 26048348 DOI: 10.1007/s11136-015-1038-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Due to the problem of high ceiling effects of the EQ-5D-3L, the EQ-5D-5L was developed. However, little was known about the full psychometric properties of the EQ-5D-5L. Thus, this study aimed to evaluate its practicality, reliability, validity, and responsiveness in Thai patients with chronic diseases. METHODS One thousand one hundred and fifty-six adults taking a medicine at least 3 months were identified from three university hospitals in Bangkok, Thailand, between July 2014 and March 2015. Practicality was evaluated by administration times and ceiling effects. Test-retest reliability was assessed using weighted kappa and intraclass correlation coefficients (ICCs). Validity was tested with correlations between the EQ-5D-5L and WHOQoL-BREF and SF-12v2, and known-groups validity. Responsiveness was measured with standardized effect sizes (SES). RESULTS The mean administration time was approximately 2 min, and the ceiling effect of the EQ-5D-5L index was 13.6 %. The weighted kappa values and ICC of the EQ-5D-5L were 0.48-0.61 and 0.82, respectively. Similar dimensions of the EQ-5D-5L had higher correlations with those of WHOQoL-BREF and SF-12v2. As expected, elderly, female, low-educated, unemployed, higher number of comorbidities and medicines, patients' perception of poor disease control, and having an adverse drug reaction tended to have poorer EQ-5D-5L scores. The SES of EQ-5D-5L index and EQ-VAS were considered small (0.33-0.42) for the improved group. For the worsened group, the SES of the EQ-5D-5L index were considered small (-0.29) but that of the EQ-VAS considered large (-0.82). CONCLUSIONS The EQ-5D-5L was practical, reliable, valid, and responsive in Thai patients with chronic diseases.
Collapse
|
34
|
Maia Costa Cabral D, Sawaya Botelho Bracher E, Dylese Prescatan Depintor J, Eluf-Neto J. Chronic pain prevalence and associated factors in a segment of the population of São Paulo City. THE JOURNAL OF PAIN 2014; 15:1081-1091. [PMID: 25038400 DOI: 10.1016/j.jpain.2014.07.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 06/24/2014] [Accepted: 07/01/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED A cross-sectional epidemiologic survey was performed to determine the prevalence of chronic pain (CP) and to identify associated factors in a random sample of persons 15 years or older from a segment of the population of São Paulo City, Brazil. A total of 1,108 eligible participants were randomly selected, and face-to-face interviews were performed with 826 individuals (74.5%) between December 2011 and February 2012. Chronic Pain Grade, Hospital Anxiety and Depression Scale, and EuroQol-5D were used to verify pain characteristics and the associated signs of psychological distress. A prevalence of 42% (95% confidence interval, 38.6-45.4) was observed for CP, and the participants with CP had an average pain intensity of 5.9 (standard deviation = 1.9) and a pain-related disability of 4.1 (standard deviation = 3.2) on a 0 to 10 scale. Persistent pain was present in 68.6% of those with CP, and 32.8% of the population sample had high-intensity or high-interference pain (Chronic Pain Grade II, III, and IV). Quality of life was significantly worse among the CP individuals. The following factors were independently associated with CP: female gender, age 30 years or older, ≤ 4 years of education, symptoms consistent with anxiety, and intense physical strain. Indicators of pain severity increased with pain grades. PERSPECTIVE CP is highly prevalent in the city of São Paulo and has a considerable impact on health-related quality of life. Demographic, socioeconomic, and psychological factors are independently associated with this condition.
Collapse
Affiliation(s)
| | | | | | - José Eluf-Neto
- University of São Paulo School of Medicine, São Paulo, Brazil
| |
Collapse
|
35
|
Luo N, Wang P, Thumboo J, Lim YW, Vrijhoef HJM. Valuation of EQ-5D-3L health states in Singapore: modeling of time trade-off values for 80 empirically observed health states. PHARMACOECONOMICS 2014; 32:495-507. [PMID: 24519603 DOI: 10.1007/s40273-014-0142-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study was to establish an EQ-5D-3L value set using the time trade-off (TTO) method to elicit the health preferences of the general Singaporean population. METHODS The values of 80 EQ-5D-3L health states were elicited from a general Singaporean population sample using a TTO method. In face-to-face interviews, participants were asked to value a block of ten health states. Various linear regression models were examined to assess for goodness of fit to the data, at both aggregate and individual levels. Prediction precision was assessed in terms of mean absolute error (MAE), and numbers of prediction errors larger than 0.10 and 0.20. Prediction consistency and bias were also assessed. RESULTS A total of 456 participants provided data for this study. The N3 model without a constant estimated using the aggregate data exhibited the best fit of the data, predicted values with the least bias, and generated logically consistent values for all 243 EQ-5D-3L health states. The MAE was 0.1137, and 35 of 80 predicted values had errors less than 0.10 in absolute magnitude. Based on this model, the utility values ranged from 0.854 for state 11121 to -0.769 for state 33333. CONCLUSIONS The EQ-5D-3L value set can be estimated using the TTO method in the multi-cultural, multi-ethnic Singapore. Although the estimation precision is not optimal, the health-state preference values generated in this study are useful to health service researchers in the country before estimates with smaller errors are available.
Collapse
Affiliation(s)
- Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, Block MD3, Singapore, 117597, Singapore,
| | | | | | | | | |
Collapse
|
36
|
Wang X, Lamoureux E, Zheng Y, Ang M, Wong TY, Luo N. Health burden associated with visual impairment in Singapore: the Singapore epidemiology of eye disease study. Ophthalmology 2014; 121:1837-42. [PMID: 24768238 DOI: 10.1016/j.ophtha.2014.03.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 02/23/2014] [Accepted: 03/11/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore. DESIGN Population-based cross-sectional study. PARTICIPANTS We studied the 10 009 adults (3353 Chinese, 3397 Indians, and 3259 Malays) who underwent a comprehensive eye assessment and completed the European Quality of Life-5 Dimensions (EQ-5D) questionnaire in the Singapore Epidemiology of Eye Disease Study. METHODS We estimated the effects of VI, obesity, hypertension, diabetes, and hyperlipidemia on the EQ-5D index score using linear regression models and the association between VI and self-reported EQ-5D health problems using logistic regression models. We compared prevalence-based quality-adjusted life-year (QALY) loss associated with VI and other health conditions. For each condition, QALY loss was calculated for 100 000 persons in 1 year using associated reduction in EQ-5D index score estimated in regression analysis as disutility. MAIN OUTCOME MEASURES The EQ-5D index score and annual QALY loss. RESULTS The EQ-5D index score decreased with increasing VI severity in all 3 ethnicities. For example, after adjusting for sociodemographic characteristics, the difference in EQ-5D index score between adults with bilateral severe VI and those without VI was -0.044 (95% confidence interval [CI], -0.089 to 0.001) in Chinese, -0.127 (95% CI, -0.237 to -0.017) in Indians, and -0.085 (95% CI, -0.148 to -0.022) in Malays. In all 3 ethnicities, VI was associated with reporting of problems in mobility (e.g., odds ratio [OR], 3.69 for Chinese with bilateral severe VI; 95% CI, 1.21-12.13) and usual activities (e.g., OR, 6.51 for Chinese with bilateral severe VI; 95% CI, 1.59-26.58). In Indians, VI was also associated with anxiety or depression (e.g., OR, 2.68 for bilateral severe VI; 95% CI, 1.11-6.50). The annual QALY loss associated with VI was 511.8 in Chinese, 608.8 in Indians, and 706.7 in Malays, greater than that associated with other health conditions examined in this study. CONCLUSIONS Visual impairment is associated with substantial health burden among Asians in Singapore. The relatively high burden of VI highlights the importance of VI prevention. The ethnic difference exhibited in this burden warrants further study.
Collapse
Affiliation(s)
- Xingzhi Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore
| | - Ecosse Lamoureux
- Singapore Eye Research Institute, Republic of Singapore; Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; Duke-NUS, Graduate Medical School, Republic of Singapore
| | - Yingfeng Zheng
- Singapore Eye Research Institute, Republic of Singapore; Department of Ophthalmology, National University of Singapore, Republic of Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Republic of Singapore
| | - Tien Yin Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore; Singapore Eye Research Institute, Republic of Singapore; Department of Ophthalmology, National University of Singapore, Republic of Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore.
| |
Collapse
|
37
|
Responsiveness of the EuroQol EQ-5D and Hospital Anxiety and Depression Scale (HADS) in rheumatoid arthritis patients receiving tocilizumab. Clin Rheumatol 2014; 33:1055-60. [PMID: 24752345 DOI: 10.1007/s10067-014-2609-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 02/24/2014] [Accepted: 03/31/2014] [Indexed: 10/25/2022]
Abstract
The aim of this study was to assess the responsiveness to change of the quality of life evaluated by the EuroQol Five Dimensions Questionnaire (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) after biological treatment in a population of rheumatoid arthritis patients. A cohort of patients with RA (n = 29) treated with tocilizumab (TCZ) were analyzed in the study. The inclusion criteria were patients aged between 18 and 65 years, fulfilling American College of Rheumatology 1987 criteria for RA. All patients had inadequate response to methotrexate and with no prior biologic exposure. They were evaluated clinically including Disease Activity Score 28 (DAS28), and the European Quality of Life 5 Dimensions (EQ-5D) to measure the quality of life, and HAD assessed the anxiety and depression status at the initiation of treatment with anti-IL 6 receptor antibody agent and after 6 months. Sensitivity to change was quantified by the effect size (ES) before and after the treatment with TCZ. Among 29 patients with RA included in the study, 25 were females and 4 males. The mean age was 42 years ± 13.4 (SD). Three patients were excluded from the study before 24 weeks because of serious side effects, and five have missing data. The study population exhibited significant decreases in all measures of disease activity at 24 weeks. Physical activity expressed by the Health Assessment Questionnaire (HAQ) score increased through the observation period (for all p < 0.001). Sensitivity to change was high for the VAS and EQ-5D (ES 1.58 and 1.36, respectively) but only moderate for the HAD anxiety component (ES = 0.70) and small for the HAD depression component (ES = 0.4). The EQ-5D and VAS were more responsive than HADS to evaluate the quality of life on patient with RA treated with TCZ.
Collapse
|
38
|
Abstract
PURPOSE To assess the construct validity and responsiveness of the EuroQoL-5D (EQ-5D) instrument in Asian patients undergoing cataract surgery in Singapore. METHODS In this prospective study, English- or Chinese-speaking patients (n = 216) completed the EQ-5D and the VF-14 questionnaires before and 3 months after they underwent cataract surgery. The impact of cataracts on patients was assessed using two standard gamble (SG) questions before surgery. Construct validity of the EQ-5D index and the visual analog scale (VAS) was assessed by examining their correlation with the VF-14 and SG scores. Responsiveness of the EQ-5D was compared with that of the VF-14 in terms of the magnitude of score change associated with cataract surgery. RESULTS We found that the EQ-5D index correlated with VF-14, SG (death), and SG (blindness) (Pearson r = 0.30, 0.23 and 0.24, respectively; p < 0.01). In contrast, we found no correlation between the EQ-VAS, VF-14, and SG scores. The mean EQ-5D index (difference, 0.06; effect size, 0.35) and VF-14 score (difference, 1.75; effect size, 0.97) of patients improved after cataract surgery (p < 0.0001). CONCLUSIONS Our study demonstrated that the EQ-5D utility index is a valid and responsive outcome measure for evaluating the impact of cataract surgery in our Asian population. However, the implications of using the generic EQ-5D instrument to assess the cost-effectiveness of surgical interventions for visual impairment require further investigation.
Collapse
|
39
|
Lim SL, Lin X, Chan YH, Ferguson M, Daniels L. A Pre-post Evaluation of an Ambulatory Nutrition Support Service for Malnourished Patients Post Hospital Discharge: A Pilot Study. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2013. [DOI: 10.47102/annals-acadmedsg.v42n10p507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Malnutrition is common among hospitalised patients, with poor follow up of nutrition support post-discharge. Published studies on the efficacy of ambulatory nutrition support (ANS) for malnourished patients post-discharge are scarce. The aims of this study were to evaluate the rate of dietetics follow-up of malnourished patients post discharge, before (2008) and after (2010) implementation of a new ANS service, and to evaluate nutritional outcomes post-implementation. Materials and Methods: Consecutive samples of 261 (2008) and 163 (2010) adult inpatients referred to dietetics and assessed as malnourished using Subjective Global Assessment (SGA) were enrolled. All subjects received inpatient nutrition intervention and dietetic outpatient clinic follow-up appointments. For the 2010 cohort, ANS was initiated to provide telephone follow-up and home visits for patients who failed to attend the outpatient clinic. Subjective Global Assessment, body weight, quality of life (EQ-5D VAS) and handgrip strength were measured at baseline and five months post-discharge. Paired t-test was used to compare pre- and post-intervention results. Results: In 2008, only 15% of patients returned for follow-up with a dietitian within four months post-discharge. After implementation of ANS in 2010, the follow-up rate was 100%. Mean weight improved from 44.0 ± 8.5 kg to 46.3 ± 9.6 kg, EQ-5D VAS from 61.2 ± 19.8 to 71.6 ± 17.4 and handgrip strength from 15.1 ± 7.1 kg force to 17.5 ± 8.5 kg force; P <0.001 for all. Seventy-four percent of patients improved in SGA score. Conclusion: Ambulatory nutrition support resulted in significant improvements in follow-up rate, nutritional status and quality of life of malnourished patients post-discharge.
Key words: Home visit, Malnutrition, Outcomes, Telephone, 7-point Subjective Global Assessment
Collapse
Affiliation(s)
| | | | - Yiong Huak Chan
- Yong Loo Lin School of Medicine, National University Health System, Singapore
| | | | - Lynne Daniels
- School of Exercise & Nutritional Sciences, Queensland University of Technology, Australia
| |
Collapse
|
40
|
Impact of self-reported smoking status on health-related quality of life in Singapore. J Public Health (Oxf) 2013. [DOI: 10.1007/s10389-013-0567-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
41
|
Measuring health-related quality of life among adults in Singapore: population norms for the EQ-5D. Qual Life Res 2013; 22:2983-91. [DOI: 10.1007/s11136-013-0405-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2013] [Indexed: 12/22/2022]
|
42
|
Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine. Spine J 2013; 13:391-6. [PMID: 23253692 DOI: 10.1016/j.spinee.2012.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Revised: 02/26/2012] [Accepted: 11/08/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The EuroQol (EQ-5D) is a widely used comprehensive measure of health-related quality of life. There has been no study that has evaluated the health-related quality of life before and after the surgical reconstruction of rheumatoid arthritis (RA) cervical spine lesions using EQ-5D. PURPOSE The present study aimed to evaluate the improvement of quality of life before and after surgical reconstruction of rheumatoid cervical spine using EQ-5D, and the surgical outcomes of cervical spine affected by RA. STUDY DESIGN A retrospective study of the patients who underwent surgical reconstruction of cervical disorders in RA. PATIENT SAMPLE Twenty-five patients (seven men, 18 women, mean age 62.2 years) who underwent surgical reconstruction of cervical disorders in RA were enrolled. OUTCOME MEASURES Japanese Orthopaedic Association (JOA) score and EQ-5D. METHODS Clinical symptoms were evaluated before surgery and at 2 years after surgery by measuring the JOA score. We also investigated health-related quality of life before surgery and outcome at 2 years after surgery using the EQ-5D questionnaire. RESULTS Mean observation period was 46.3 months. Mean JOA score significantly improved from 9.1 ± 4.5 points before surgery to 12.4 ± 2.8 at the 2 years after surgery (p=.0001). All the EQ-5D data were improved at the 2 years after surgery, compared with the data before surgery; especially, pain (p=.005), usual activity (p=.005), mobility (p=.008), and anxiety/depression (p=.02) were significantly improved. Utility weight was 0.37 ± 0.27 before surgery and 0.56 ± 0.26 at the 2 years after surgery, showing significant improvement at the 2 years after surgery compared to before surgery (p=.002). CONCLUSIONS The surgical reconstruction of rheumatoid cervical spine has been demonstrated to improve patients' health-related quality of life.
Collapse
|
43
|
Leung YY, Png ME, Wee HL, Thumboo J. Comparison of EuroQol-5D and short form-6D utility scores in multiethnic Asian patients with psoriatic arthritis: a cross-sectional study. J Rheumatol 2013; 40:859-65. [PMID: 23504382 DOI: 10.3899/jrheum.120782] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare EuroQol-5D (EQ-5D) and Short Form-6D (SF-6D) utility scores in multiethnic Asian patients with psoriatic arthritis (PsA). METHODS Consecutive patients fulfilling the Classification Criteria for Psoriatic Arthritis attending a rheumatology outpatient clinic were recruited and completed the EQ-5D and SF-6D questionnaires. Comparisons were performed by score distribution, mean, median, and the Outcome Measures in Rheumatology filter: i.e., truth, discrimination, and feasibility. RESULTS Eighty-six patients were enrolled (69 English-speaking and 17 Chinese-speaking; male:female ratio 0.91). The score distribution of SF-6D was normal, while that of EQ-5D was bimodal. A ceiling effect was observed in 20% of patients for EQ-5D and none for SF-6D. There were moderate correlations (Spearman's rho = 0.59, p < 0.0001) between the 2 scores, but poor agreements on scatterplot, intraclass correlation (ICC 0.43 and standardized ICC 0.21), and Bland-Altman plots. EQ-5D generated lower utility scores than SF-6D in the poorer health subgroup. SF-6D had stronger correlation with the general health status and other external measures of health; and it distinguished better between good and poor general health status, with better effect size and relative efficiency statistics. EQ-5D demonstrated higher patient acceptability. CONCLUSION EQ-5D and SF-6D instruments generated different utility scores in PsA. SF-6D may be superior because of normal scaling distribution and the absence of ceiling and floor effects. SF-6D also had better construct validity and better discrimination of poor health status. More studies are required for cost-utility analysis in PsA.
Collapse
Affiliation(s)
- Ying-Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.
| | | | | | | |
Collapse
|
44
|
Castelino M, Abbott J, McElhone K, Teh LS. Comparison of the psychometric properties of health-related quality of life measures used in adults with systemic lupus erythematosus: a review of the literature. Rheumatology (Oxford) 2012; 52:684-96. [PMID: 23264550 DOI: 10.1093/rheumatology/kes370] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE A review of the literature was undertaken to evaluate the development and psychometric properties of health-related quality of life (HRQoL) measures used in adults with SLE. This information will help clinicians make an informed choice about the measures most appropriate for research and clinical practice. METHODS Using the key words lupus and quality of life, full original papers in English were identified from six databases: OVID MEDLINE, EMBASE, Allied and Complementary Medicine, Psychinfo, Web of Science and Health and Psychosocial Instruments. Only studies describing the validation of HRQoL measures in adult SLE patients were retrieved. RESULTS Thirteen papers were relevant; five evaluated generic instruments [QOLS-S (n = 1), EQ-5D/SF-6D (n = 1), SF-36 (n = 3)] and eight evaluated disease-specific measures [L-QOL (n = 1), LupusQoL (UK) (n = 1), LupusQoL (US) (n = 1), SSC (n = 2), SLEQOL (n = 3)]. For the generic measures, there is moderate evidence of good content validity and internal consistency, whereas there is strong evidence for both these psychometric properties in disease-specific measures. There is limited to moderate evidence to support the construct validity and test-retest reliability for the disease-specific measures. Responsiveness and floor/ceiling effects have not been adequately investigated in any of the measures. CONCLUSIONS Direct comparison of the psychometric properties was difficult because of the different methodologies employed in the development and evaluation of the different HRQoL measures. However, there is supportive evidence that multidimensional disease-specific measures are the most suitable in terms of content and internal reliability for use in studies of adult patients with SLE.
Collapse
|
45
|
Health state utilities and quality of life in patients with hepatitis B. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2012; 26:445-51. [PMID: 22803020 DOI: 10.1155/2012/736452] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The effect of chronic hepatitis B (CHB) infection on health-related quality of life (HRQoL) and health state utilities has not been well characterized. OBJECTIVE To measure utility scores and HRQoL across disease states associated with CHB infection. METHODS Patients attending four tertiary care clinics for CHB were approached between July 2007 and March 2009. Respondents completed version 2 of the Short-Form 36 Health Survey, the EQ5D, a visual analogue scale, the Health Utilities Index Mark 3, standard gamble, and demographics and risk factor surveys in English, Cantonese or Mandarin. Charts were reviewed to determine disease stage and comorbidities. RESULTS A total of 433 patients were studied: 294 had no cirrhosis; 79 had compensated cirrhosis; seven had decompensated cirrhosis; 23 had hepatocellular carcinoma; and 30 had received a liver transplant. The mean standard gamble utilities for these disease states were 0.89, 0.87, 0.82, 0.84 and 0.86, respectively. HRQoL scores in noncirrhotic patients were similar to those of the general population. Scores of patients with compensated cirrhosis were not significantly lower; however, patients with decompensated cirrhosis and hepatocellular carcinoma had significantly lower HRQoL scores compared with noncirrhotic patients (P<0.05). Similar scores were observed among patients on and off oral antiviral treatment. Post-liver transplant patients had a higher HRQoL than patients with decompensated cirrhosis. Age, number of comorbidities and relationship status were significantly associated with HRQoL scores. CONCLUSIONS HRQoL in CHB patients is only impaired in the later stages of liver disease. Neither CHB infection nor antiviral treatment is associated with a lower quality of life.
Collapse
|
46
|
Kimman M, Vathesatogkit P, Woodward M, Tai ES, Thumboo J, Yamwong S, Ratanachaiwong W, Wee HL, Sritara P. Validity of the Thai EQ-5D in an occupational population in Thailand. Qual Life Res 2012; 22:1499-506. [DOI: 10.1007/s11136-012-0251-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2012] [Indexed: 10/28/2022]
|
47
|
McPhail S, Haines T. Patients undergoing subacute rehabilitation have accurate expectations of their health-related quality of life at discharge. Health Qual Life Outcomes 2012; 10:94. [PMID: 22901009 PMCID: PMC3495730 DOI: 10.1186/1477-7525-10-94] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 08/02/2012] [Indexed: 11/16/2022] Open
Abstract
Background Expectations held by patients and health professionals may affect treatment choices and participation (by both patients and health professionals) in therapeutic interventions in contemporary patient-centered healthcare environments. If patients in rehabilitation settings overestimate their discharge health-related quality of life, they may become despondent as their progress falls short of their expectations. On the other hand, underestimating their discharge health-related quality of life may lead to a lack of motivation to participate in therapies if they do not perceive likely benefit. There is a scarcity of empirical evidence evaluating whether patients’ expectations of future health states are accurate. The purpose of this study is to evaluate the accuracy with which older patients admitted for subacute in-hospital rehabilitation can anticipate their discharge health-related quality of life. Methods A prospective longitudinal cohort investigation of agreement between patients’ anticipated discharge health-related quality of life (as reported on the EQ-5D instrument at admission to a rehabilitation unit) and their actual self-reported health-related quality of life at the time of discharge from this unit was undertaken. The mini-mental state examination was used as an indicator of patients’ cognitive ability. Results Overall, 232(85%) patients had all assessment data completed and were included in analysis. Kappa scores ranged from 0.42-0.68 across the five EQ-5D domains and two patient cognition groups. The percentage of exact correct matches within each domain ranged from 69% to 85% across domains and cognition groups. Overall 40% of participants in each cognition group correctly anticipated all of their self-reported discharge EQ-5D domain responses. Conclusions Patients admitted for subacute in-hospital rehabilitation were able to anticipate their discharge health-related quality of life on the EQ-5D instrument with a moderate level of accuracy. This finding adds to the foundational empirical work supporting joint treatment decision making and patient-centered models of care during rehabilitation following acute illness or injury. Accurate patient expectations of the impact of treatment (or disease progression) on future health-related related quality of life is likely to allow patients and health professionals to successfully target interventions to priority areas where meaningful gains can be achieved.
Collapse
Affiliation(s)
- Steven McPhail
- Centre for Functioning and Health Research, Buranda, Brisbane, Australia.
| | | |
Collapse
|
48
|
Shim YT, Lee J, Toh MPHS, Tang WE, Ko Y. Health-related quality of life and glycaemic control in patients with Type 2 diabetes mellitus in Singapore. Diabet Med 2012; 29:e241-8. [PMID: 22507291 DOI: 10.1111/j.1464-5491.2012.03689.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIMS To investigate the health-related quality of life of patients with diabetes mellitus in Singapore and its associations with diabetes-related characteristics and glycaemic control. METHODS An interviewer-administered, cross-sectional survey was conducted in a sample of 301 adult diabetes patients under primary care. The survey questionnaire included both a generic health-related quality of life measure, the Euroqol 5-D and a diabetes-specific instrument, the Audit of Diabetes-dependent Quality of Life. Patients' most recent HbA(1c) values were extracted from their medical records. RESULTS After excluding patients who lacked the 90-day HbA(1c) test result, the final number of responses analysed was 282. Pain/discomfort was the most common complaint among the five Euroqol 5-D domains (by 28.0% of the respondents). Lack of freedom to eat was the Audit of Diabetes-dependent Quality of Life domain with the greatest negative average weighted impact (= -3.8, on a scale of -9 to 3). A significant association was observed between Audit of Diabetes-dependent Quality of Life average weighted impact and both duration of diabetes and use of insulin. A negative correlation was found between health-related quality of life and HbA(1c) values in both health-related quality of life measures (both r=-0.2, P=0.001). CONCLUSIONS Patients with diabetes in primary-care settings frequently reported problems with pain/discomfort and restrictions in diet. Poorer health-related quality of life was found to be associated with higher HbA(1c) values. The chronicity of diabetes and insulin therapy may have a negative impact on patients' diabetes-related health-related quality of life. This study indicates the importance of achieving better disease management to improve the health-related quality of life of patients with diabetes.
Collapse
Affiliation(s)
- Y T Shim
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | | | | | | | | |
Collapse
|
49
|
Gignac MAM, Cao X, Mcalpine J, Badley EM. Measures of disability: Arthritis Impact Measurement Scales 2 (AIMS2), Arthritis Impact Measurement Scales 2-Short Form (AIMS2-SF), The Organization for Economic Cooperation and Development (OECD) Long-Term Disability (LTD) Questionnaire, EQ-5D, World Health Organization Disability Assessment Schedule II (WHODASII), Late-Life Function and Disability Instrument (LLFDI), and Late-Life Function and Disability Instrument-Abbreviated Version (LLFDI-Abbreviated). Arthritis Care Res (Hoboken) 2012; 63 Suppl 11:S308-24. [PMID: 22588753 DOI: 10.1002/acr.20640] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Monique A M Gignac
- Toronto Western Research Institute, and University of Toronto, Toronto, Ontario, Canada.
| | | | | | | |
Collapse
|
50
|
Zhang XH, Tan K, Tan HH, Thumboo J, Li SC. Are English and Chinese Versions of the Audit of Diabetes-Dependent Quality of Life Equivalent? An Exploratory Study Based on the Universalist Approach. Value Health Reg Issues 2012; 1:75-81. [DOI: 10.1016/j.vhri.2012.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|